May 19 Does Chondroitin Sulfate Help Treat Osteoarthritis? A Review of the Evidence

Let’s take a few minutes to talk about Chondroitin also known as Chondroitin Sulfate. This is a commonly used supplement, especially by folks with osteoarthritis looking to protect their bones and joints, and I thought it would be worth reviewing the evidence surrounding this particular supplement. Glucosamine is another supplement commonly taken with Chondroitin, often from the same pill, but I will discuss that in another lecture.

Chondroitin is a molecular structure that falls into the category of glycosaminoglycans. Glycosaminoglycans are polysaccharides essentially composed of chains of different types of repeating sugars with proteins and uronic acids attached. (It is more complicated than that, but that simplified version is easy to remember). The purpose of glycosaminoglycans is to act as the bodies natural lubricant and shock absorber for joints. It is an essential component of the structural integrity of the cells in your body, especially in cartilage. Although there are many types, chondroitin sulfate is the most well known and the most common in the body which is why it is the most often supplemented.

Chondroitin is most frequently taken to alleviate the effects of osteoarthritis and, perhaps, other joint diseases. The evidence is mixed on whether this drug is helpful for treating the disease and I’ll try to briefly summarize that evidence for you.

A 2007 systematic review (Health Technology Assessment, Black et al.) found “There was evidence that glucosamine sulphate shows some clinical effectiveness in the treatment of OA of the knee.” However they recommended interpreting these results with caution for a variety of reasons.

A 2006 study published in the New England Journal of Medicine (Clegg, et al.) assessed the results of a double blind placebo controlled study of glucosamine and chondroitin (as well as celecoxib). They concluded “Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain. “

Perhaps the most informative publication is a 2010 (British Medical Journal, Wandel et al.) meta analysis that included 10 different trials of chondroitin sulfate (as well as glucosamine). The authors of this study concluded “Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space.” Interestingly, this study also found that trials funded by industry had larger effect sizes than those funded by industry.

It is in light of this strong evidence that medical professionals are increasingly skeptical of the benefits of supplementing chondroitin. That said, it’s side effect profile is relatively benign and most folks can supplement it safely. It’s up to you whether you want to supplement chondroitin, but just be aware that it may not be helping with your joint pain.